<div class="form">
    <h3>Register Newsletter</h3>
    <form method="post" action="<?php echo $this->action ?>" id="newsletter-form">
        <?php if($this->requireName) : ?>
        <div class="row">
            <label>First name <span class="required">*</span></label>
            <input type="text" name="firstname" id="newsletter-firstname" />
        </div>
        <div class="row">
            <label>Last name <span class="required">*</span></label>
            <input type="text" name="lastname" id="newsletter-lastname" />
        </div>
        <?php endif; ?>
        <div class="row">
            <label>Email <span class="required">*</span></label>
            <input type="text" name="email" id="newsletter-email" />
        </div>
        <div class="row">
            <input type="submit" value="Submit" />
        </div>
    </form>
</div><!-- form -->